Civility in Health Care: A Moral Imperative

Civility is an essential feature of health care, as it is in so many other areas of human interaction. The article examines the meaning of civility, reviews its origins, and provides reasons for its moral significance in health care. It describes common types of uncivil behavior by health care professionals, patients, and visitors in hospitals and other health care settings, and it suggests strategies to prevent and respond to uncivil behavior, including institutional codes of conduct and disciplinary procedures. The article concludes that uncivil behavior toward health care professionals, patients, and others subverts the moral goals of health care and is therefore unacceptable. Civility is a basic professional duty that health care professionals should embrace, model, and teach.

Vital Conversations: An Interactive Conflict Resolution Training Session for Fourth-Year Medical Students

INTRODUCTION

The AAMC has recognized the importance of effective teamwork and collaboration. One core Entrustable Professional Activity emphasizes creating a climate of mutual respect and trust and prioritizing team needs over personal needs, which leads to safe, timely, effective, efficient, and equitable patient care. Relationship conflicts, specifically, are associated with decreased productivity, complex information processing, and work satisfaction. Given the prevalence of conflict and its impact on health care workers, the lack of conflict resolution curricula in undergraduate medical education is surprising. We developed a curriculum formally introducing these skills and allowing practice in a simulated environment before students entered residency.

METHODS

Fourth-year medical students completed a conflict resolution exercise in a mandatory transition-to-residency course. Students completed online prework including reflection on teamwork and information on conflict resolution styles, participated in a simulated conflict with a standardized patient acting as a nurse, and afterward completed a self-evaluation with video review by the students' assigned coach and feedback on the session.

RESULTS

We collected complete responses from 108 students. We evaluated the curriculum for feasibility and acceptability by faculty and students. Most students agreed with faculty on their entrustment and milestone levels. Students found that the session prompted self-reflection and was a good review of conflict resolution. The standardized patient and faculty feedback was found to be the most useful by the students.

DISCUSSION

We successfully implemented a simulated but realistic conflict resolution exercise. Students found the exercise helpful in their preparation for residency.

'Youth's Conflict Resolution Strategies in their Dating Relationships'

Youth can experience conflicts with their dating partner and then need strategies to solve such conflicts. Research is scarce regarding positive conflict resolution strategies in a dating context. Considering research on various interpersonal relationships (e.g. friendships, dating, marriage), the present study examined how dimensions of empathy, verbal skills and impulsivity can contribute to the use of positive conflict resolution strategies in dating relationships. The sample is made up of 813 youth attending secondary schools or a regional college (71.7% female, mean age = 18.9, age range 14.2-24.9). They completed self-administered questionnaires investigating positive conflict resolution strategies, as well as dimensions of empathy (i.e., fantasy, perspective-taking, empathic concern, and personal distress), verbal skills (similarities and figurative language) and impulsivity (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking). The results reveal sex differences and developmental improvements on several factors. The findings showed that specific dimensions of empathy and verbal skills foster the use of positive conflict resolution strategies whereas specific dimensions of impulsivity and one dimension of empathy hamper it. Both sexes shared a common correlate: the propensity toward perspective-taking fostered the use of positive conflict resolution strategies. In addition to highlighting correlates of positive conflict resolution strategies in dating relationships, this study can contribute to programs dedicated to the promotion of healthy dating relationships among adolescents and emerging adults.

Wellness Skills for Medical Learners and Teachers: Perspective Taking and Cognitive Flexibility

INTRODUCTION

Wellness insufficiency is a widespread problem in medical training programs. Recent evidence reveals that one factor contributing to physician wellness is cognitive flexibility, defined as being able to hold multiple views or to reframe a thought, situation, or perspective. While cognitive flexibility is a neurologically based, teachable skill, there is little guidance as to how to build this skill in learners (and teachers).

METHODS

This workshop introduces the concept and relevance of cognitive flexibility as a wellness skill and then utilizes the novel methodology of reverse role-play through simulated stressful everyday encounters in medical education between teachers and learners.

RESULTS

This workshop successfully improved cognitive flexibility scores in a sample of 15 family medicine residents, according to measures on the Cognitive Flexibility Scale.

DISCUSSION

By incorporating cognitive flexibility and perspective-taking skill instruction, this resource has implications for reducing conflict and stress, as well as improving the wellness levels of medical students, residents, and faculty alike.

Marital Satisfaction and Its Influencing Factors in Fertile and Infertile Women

Objective: To determine marital satisfaction and its influencing factors among fertile and infertile women in Shahroud. Materials and methods: In this comparative study, 1528 participants (511 infertile and1017 fertile women) were evaluated using Enrich Marital Satisfaction Scale. Data were analyzed using chi-square and t-test. Results: A total of 1402 participants (78.7%) had high marital satisfaction. The results show that no significant differences exist between marital satisfaction, marital communication, conflict resolution and idealistic distortion in fertile and infertile women. However, a significant difference was observed between marital satisfaction, and job, spouse's job and income in fertile and infertile groups, but the place of residence, education, spouse's education and fertility status showed no significant difference. Conclusion: Results showed that infertility does not reduce marital satisfaction. Since marital satisfaction is moderate in both groups, sex education for people bound to marry and sexual counseling for couples can lead to improved sexual satisfaction.

Case Study of an Unsustainable Community-Academic Partnership: Toward Core Standards for the Structure of Emerging Participatory Research

This report retrospectively examines the structure of an emerging community-academic participatory research (PR) partnership that was not sustainable, despite attempts to adhere to PR principles and demonstrable success in research outcomes. The influence of community and academic parent organizations on the PR process and outcomes is presented in the context of the Donabedian Model. We dissected the structural elements contributed by parent organizations to forming the structure of the PR partnership (memorandum of understanding, policy environment, human resources and effort, community and academic resources, expertise and experience, and funding) and explored the influence of potential and actual conflicts on the PR partnership's sustainability. The effect of potential and actual conflict on the PR process and quality of PR outcomes is discussed. Based on this, we conclude by proposing seven core standards for the establishment and development of emerging community-academic PR partnerships.